UroToday - AUA 2008 - Society of Urologic Oncology Meeting - Perineal Biopsy Versus Saturation Biopsy - Case Presentation to Panel

May 18, 2008

Saturday, 17 May 2008

ORLANDO, FL

(UroToday.com) - Dr. Carroll asked if there was a role for perineal biopsy vs.

saturation biopsy. Dr. Presti would perform saturation biopsies transrectally.

Dr. Andriole recommended a grid using a template, such as the TARGET that is in

clinical trial.

Dr.

Getzenberg addressed the use of the Multiplex assay and use of EPCA tests in

initial screening. The preliminary data for EPCA in this population is over 90%

sensitivity. However, a multiplex approach incorporating several markers may

prove powerful. Combining a highly sensitive marker with a highly specific

marker might enhance the ROC curves for detection.

The

question was posed regarding performing MRI guided biopsy. Dr. Presti stated

that combining MRI with biopsy through fusion software to combine the images is

under investigation. Otherwise, it can not be determined exactly where to

biopsy the areas that are concerning on MRI. Dr. Carroll stated that lesions

less that 5mm are missed in the UCSF experience.

Dr. Klotz

supported the use of risk calculators as a method to determine who needs a

repeat biopsy. A discussion was had on end-fire vs. side-fire biopsy probes.

The end fire gun is better for some biopsy angles, was a comment.

PSA

velocity was addressed and the data was generated using a long-term database

and may not be applicable to the clinical practice over a shorter duration.

Regarding the best patient for chemoprevention, it was felt that high risk

patients should be treated, not low risk. Dr. Andriole could not yet commit

that dutasteride was superior to finasteride, but the data would have to prove

this. It would be cost-ineffective to give chemoprevention to low risk

patients.

Moderated

by ph Presti, MD, with Gerald Andriole, MD, Getzenberg, MD,

Steiner, MD, and ce Klotz,

MD, at the Annual Meeting of the

American Urological Association (AUA) - May 17 - 22, 2008. Orange County

Convention Center - Orlando, Florida, USA.

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